Provider Demographics
NPI:1164722658
Name:OPEN ARMS COMMUNITY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:OPEN ARMS COMMUNITY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:SERVIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-751-8371
Mailing Address - Street 1:10645 NW 7TH AVE
Mailing Address - Street 2:SUITE 103-104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-1066
Mailing Address - Country:US
Mailing Address - Phone:305-751-8373
Mailing Address - Fax:305-751-8375
Practice Address - Street 1:10645 NW 7TH AVE
Practice Address - Street 2:SUITE 103-104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-1066
Practice Address - Country:US
Practice Address - Phone:305-456-9784
Practice Address - Fax:786-953-6528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-30
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105887100Medicaid